Provider Demographics
NPI:1932192291
Name:GHORBANI, ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:GHORBANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4915 AUBURN AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2636
Mailing Address - Country:US
Mailing Address - Phone:301-907-3939
Mailing Address - Fax:301-656-3943
Practice Address - Street 1:7610 CARROLL AVE
Practice Address - Street 2:SUITE 480
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6384
Practice Address - Country:US
Practice Address - Phone:301-270-4360
Practice Address - Fax:301-270-4319
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD0063672207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I28050Medicare UPIN
DC179593Medicare ID - Type Unspecified